Individual provider Active NPI

Taylor James Haslett

  • Addiction (Substance Use Disorder) Counselor
  • Mount Vernon, WA
National Provider Identifier
1619557618
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CO61421280 Issued in WA
Practice address
1905 Continental PL
Mount Vernon, WA 98273-5633
Phone
(360) 755-6405
Fax
(360) 755-6407
NPI assigned
Apr 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X WA
Addiction (Substance Use Disorder) Counselor 101YA0400X CO61421280 WA Primary

Addresses

Primary practice location

1905 Continental PL
Mount Vernon, WA 98273-5633

Mailing address

1905 Continental PL
Mount Vernon, WA 98273-5633
Phone (360) 755-6405

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL HR@evergreenrc.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CO61421280WAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1619557618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CONTINENTAL PL",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735633",
            "telephone_number": "360-755-6405",
            "fax_number": "360-755-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CONTINENTAL PL",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735633",
            "telephone_number": "360-755-6405",
            "fax_number": "360-755-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASLETT",
        "first_name": "TAYLOR",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61421280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HR@evergreenrc.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1905 Continental Pl",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982735633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.